| |
212 E B St Iron Mountain MI 49801-3411 | |
(906) 774-2990 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 212 E B St, Iron Mountain, Michigan |
Authorized Official Name and Position | Denise K Stroobants (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 9204457222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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212 E B St Iron Mountain MI 49801-3411 Ph: (906) 774-2990 | 212 E B St Iron Mountain MI 49801-3411 Ph: (906) 774-2990 |
NPI Number | 1558556985 |
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Provider Enumeration Date | 09/10/2007 |
Last Update Date | 04/06/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558556985 | NPI | - | NPPES |
21313800 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Indigo Hospital Medicine - Iron Mountain Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1721 S Stephenson Ave, Iron Mountain, MI 49801 Phone: 906-776-5415 Fax: 906-776-5402 | |